A recurring problem in learning to play the flute is the awkward positioning required of the hands and fingers for the proper placement of the musical instrument. Because of the small diameter of the tubular body of metal flutes, the left hand and left index finger must be turned inward in order for the side of the left index finger to bear against the flute and apply proper pressure on the instrument. It is this force applied by the side of the left index finger that in turn applies appropriate pressure of the flute mouthpiece against the flute player's lower lip. At the same time the left index finger must play the C' or upper C finger key while the left thumb is operating the B' or upper B and Bd' or upper B flat finger keys on the other side of the flute body. Additionally, the left index finger provides a pivot point for the flute in applying and transmitting further pressure from the right hand positioned on the lower end of the flute body to the upper end or head of the flute.
Because of the awkward position and unnatural posture required of the left hand and left index finger turned inwardly against the flute body, inexperienced players suffer fatigue and even cramping in the left fingers, wrist, and arm. Eventually, proper pressure is not applied. Fingering, particularly by the left hand, suffers as does the embouchure or embouchment referring to the proper deployment and use of the lips dependent upon proper pressure against the lower lip. The narrow diameter of the tubular body of metal flutes also presents problems for other digits including the right thumb. These difficulties present problematic hurdles for music teachers providing flute instruction and require attention even by experienced flute players.